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Sedation Practices in the PICU: An Unexpected Casualty of COVID-19

Pediatric intensivists often use an “analgosedation” approach in mechanically ventilated children. By prioritizing analgesia and minimizing sedation, patients experience less delirium. However, when COVID-19 surged, our pediatric intensive care unit providers were tasked with caring for adults with...

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Autores principales: Pumphrey, Katherine, Bouzaher, Alisha, Achuff, Barbara-Jo, Traube, Chani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9150884/
https://www.ncbi.nlm.nih.gov/pubmed/35651739
http://dx.doi.org/10.1097/CCE.0000000000000713
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author Pumphrey, Katherine
Bouzaher, Alisha
Achuff, Barbara-Jo
Traube, Chani
author_facet Pumphrey, Katherine
Bouzaher, Alisha
Achuff, Barbara-Jo
Traube, Chani
author_sort Pumphrey, Katherine
collection PubMed
description Pediatric intensivists often use an “analgosedation” approach in mechanically ventilated children. By prioritizing analgesia and minimizing sedation, patients experience less delirium. However, when COVID-19 surged, our pediatric intensive care unit providers were tasked with caring for adults with severe acute hypoxemic respiratory failure (AHRF). As documented in the literature, adults with COVID-19-AHRF received significantly higher doses of sedatives than matched cohorts with non-COVID-19 AHRF. Surprisingly, when the pediatric intensive care unit returned to caring for children, a quality review showed that we were unintentionally using far more sedatives than that prior to COVID-19. This experience is not unique to our institution, or to COVID-19. Lingering effects of crisis care can persist beyond the event itself. We seek to share our experience in order to extend the conversation regarding the unexpected effects of crises on best practices and to stress the need for high-quality research on interventions to support mental health and resilience in frontline healthcare providers.
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spelling pubmed-91508842022-05-31 Sedation Practices in the PICU: An Unexpected Casualty of COVID-19 Pumphrey, Katherine Bouzaher, Alisha Achuff, Barbara-Jo Traube, Chani Crit Care Explor Letter to the Editor Pediatric intensivists often use an “analgosedation” approach in mechanically ventilated children. By prioritizing analgesia and minimizing sedation, patients experience less delirium. However, when COVID-19 surged, our pediatric intensive care unit providers were tasked with caring for adults with severe acute hypoxemic respiratory failure (AHRF). As documented in the literature, adults with COVID-19-AHRF received significantly higher doses of sedatives than matched cohorts with non-COVID-19 AHRF. Surprisingly, when the pediatric intensive care unit returned to caring for children, a quality review showed that we were unintentionally using far more sedatives than that prior to COVID-19. This experience is not unique to our institution, or to COVID-19. Lingering effects of crisis care can persist beyond the event itself. We seek to share our experience in order to extend the conversation regarding the unexpected effects of crises on best practices and to stress the need for high-quality research on interventions to support mental health and resilience in frontline healthcare providers. Lippincott Williams & Wilkins 2022-05-27 /pmc/articles/PMC9150884/ /pubmed/35651739 http://dx.doi.org/10.1097/CCE.0000000000000713 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Letter to the Editor
Pumphrey, Katherine
Bouzaher, Alisha
Achuff, Barbara-Jo
Traube, Chani
Sedation Practices in the PICU: An Unexpected Casualty of COVID-19
title Sedation Practices in the PICU: An Unexpected Casualty of COVID-19
title_full Sedation Practices in the PICU: An Unexpected Casualty of COVID-19
title_fullStr Sedation Practices in the PICU: An Unexpected Casualty of COVID-19
title_full_unstemmed Sedation Practices in the PICU: An Unexpected Casualty of COVID-19
title_short Sedation Practices in the PICU: An Unexpected Casualty of COVID-19
title_sort sedation practices in the picu: an unexpected casualty of covid-19
topic Letter to the Editor
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9150884/
https://www.ncbi.nlm.nih.gov/pubmed/35651739
http://dx.doi.org/10.1097/CCE.0000000000000713
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